Pre-existing Conditions in Pregnancy and Pregnancy Related Conditions Flashcards

(38 cards)

1
Q

What effects has pregnancy been said to have on asthma?

A

some say worsening, better or no change, 50% say worsens later in preg

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2
Q

should pregnant women reduce asthma med dose?

A

no, ONLY if inappropriately high

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3
Q

how often should asthma meds be rvd in preg?

A

every 4 weeks

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4
Q

What are cat A asthma meds?

A

salbutamol, budesonide

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5
Q

What class of asthma meds should be avoided in pregnancy?

A

ICS and LABAs

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6
Q

When could withdrawal of antiseizure meds be considered in preg?

A

if the woman has been seizure free for >2 years

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7
Q

What antiseizure med has highest rate of birth defects?

A

valproate; NTDs, autism

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8
Q

what antiseizure meds have lowest risk in preg?

A

lamotrigine and levetiracetam

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9
Q

what percent of women using antiseizure meds in preg will have infant with major malformation?

A

2-3%

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10
Q

What are the risks of not treating depression/anxiety in pregnancy?

A

higher risk preterm, SGA, stillbirth, LBW, autism, PPD

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11
Q

what is the most preferred antidepressant in preg?

A

sertraline

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12
Q

what antidepressants are associated with heart defects in the infant?

A

paroxetine and lithium

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13
Q

what can happen to the infant if the mother has been taking antidepressant through pregnancy

A

toxicity withdrawal

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14
Q

what hypothyroidism drug is recommended in preg and what Cat is it?

A

levothyroxine Cat A

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15
Q

what percent are thyroid requirements increased in preg?

A

30% by K4-6

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16
Q

what is the risk of not treating hypothyroidism in preg?

17
Q

what cat is metformin in preg?

18
Q

What classes of antiHTsives should be avoided in preg and why?

A

ACEis: fetal renal dysfunction and death, and CCBs: fetal hypoxia

19
Q

What are the preferred antihypertensives in preg?

A

methyldopa and labetalol

20
Q

what are the second line antihypertensives in preg?

A

hydralazine, nifedipine and prazosin

21
Q

what are the parameters of GHTN?

A

140/90 after K20

22
Q

What percentage of people smoked at some point in preg?

23
Q

what are the effects of smoking in preg?

A

miscarriage, stillbirth, ectopic, placental issues, PET, SIDS, preterm, birth defects, middle ear infection, T2DM, obesity as adult

24
Q

what cat is nic replacement therapy?

25
when should nic replacement therapy be considered in preg?
when smoking >10cigs/day
26
can nic cross placenta?
yes easily
27
what is excessive caffeine linked to in preg and what is this measurement?
miscarriage >600mg daily
28
what is rec daily limit caffeine in preg?
200mg (2 cups)
29
what are the effects of cannabis in preg?
major abnormalities, APGARS req NICU, LBW
30
what can help N&V
ginger and B6
31
what antiemetics rec in preg?
doxylamine, meto, ondans, promethazine, prochlorperazine
32
what can excess N&V lead to and how is this treated?
vit deficiencies (B1, assoc Wenicke's enceph), hyperemesis gravidarium, tx with IV rehydration
33
what proportion of maternal deaths assoc VTE?
10.6%
34
how much is VTE risk increased in preg?
4-5 fold
35
when is greatest risk of VTE for mothers?
PP
36
When would heparin be CI'd for mothers?
known hypersens, hx hep induced thrombocytopenia, poor renal function EGFR <15L/min
37
can low molecular weight hep cross placenta?
no
38
when should warfarin be avoided?
T1, women with prosthetic heart valves, risk teratogenity